Personality Disorders Versus Neuroses

Over the last 30 years, numerous empirical studies have suggested it is possible to arrange defensive mechanisms into a hierarchy of relative psychopathology beginning in severity with “psychotic defenses”, and ranging through “immature defenses”, “intermediate defenses”, and finally, “mature defenses”. This article considers the immature and intermediate defenses.

An individual diagnosed with a “personality disorder” is defined as having “immature defenses” (i.e. acting out, splitting, projection) which, in terms of their effect on others, can be compared to a cigarette smoker in an elevator. Such behaviour seems innocent and understandable to the user, and deliberately irritating and provocative to the observer.

A defining quality of a person using such a defense is their tendency to externalize responsibility for their behaviour. A typical example of this is someone justifying their rude behaviour by claiming that if someone else hadn’t done such and such, then they wouldn’t have responded the way they did. In so doing, they provide justification for refusing to accept blame or responsibility for their actions, and will almost certainly refuse help.

Accordingly, such individuals tend to define other people or external events as the source of their problems. In some instances this perception can lead to self-righteous “acting out” of anger and frustration towards perceived offenders, and hence, one reason for their reputation of being difficult to get along with.

In contrast, a neurotic is said to utilize “intermediate defenses” such as intellectualization, and repression. These defenses are like a stone in the shoe; they create problems for no one but their owner. Neurotics have been characterized as defining themselves as the source of their problems which they struggle with endlessly in their own mind.

When considered strictly from an intra-psychic viewpoint, the immature defenses of the personality disordered initially seem to provide better buffering than the defenses of the neurotic.

Blaming someone else for our actions and suffering not only frees us from feelings of guilt or shame, but it also removes the responsibility of having to do anything about our actions or behaviour. In contrast, when we over-identify ourselves as the source of our problem, the blame is internalized. It is this reflection back into ourselves that transforms anger and frustration into painful experiences such as guilt, shame, and depression.

Whereas many neurotics are hypersensitive to the slights and criticisms of others, some personality disordered individuals seem impervious to and unaffected by such things. The net result of these defenses however, is that such individuals are severely restricted in their capacity to learn from others because they do not trust them. This long-standing failure in the capacity to develop appropriate social connectedness ultimately results in restricted personal development. Not only are the defenses of such individuals “immature”, so too is their entire style of living.

Unfortunately for both groups, a central characteristic of defense mechanisms is that such strategies are ultimately self-defeating and self-perpetuating; in spite of all their efforts, nothing really changes. Whether neurotic or personality disordered, both seem determined to continue in the same manner.

The personality disordered tries to stand up by pushing others down. When they complain and push back he then uses those reactions as justifications for his next round of behavior.

The neurotic tries to stand up by knocking himself down. The lack of support offered him by others who eventually tire of trying to help him stand up, or who manipulate him for his weakness, only adds to his sense of worthlessness and feelings of hopelessness.

Erich Fromm has offered the following comment on human nature; “Man is the only animal who finds his own existence a problem which he has to solve and from which he cannot escape”.

One way or another, we are all struggling with our existence. To the degree that defenses minimize the appearance of fears and anxieties, then most “normal people” seem well protected.

While I hope these general distinctions between a personality disorder and neuroses are helpful, we should not forget we all have our own disorders and neuroses. What may save us from being overtly identified in either category is our intelligence and our resourcefulness in creating and maintaining conditions that minimize the appearance of our fears and anxieties. Indeed, the mark of higher intelligence may be the degree to which we can channel our energies into productive and socially rewarding activities that more effectively shield us from our disturbances.

Finally, as I get older I increasingly wonder if the “healthy person” is a mythical creation or a category that applies only to a very select few. If caring, compassion, and the ability to love unconditionally are marks of the psychologically mature, then where are these people? Where are our wise men and women?

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3 thoughts on “Personality Disorders Versus Neuroses”

we keep chasing away the wise, mature people because they tell us the harsh reality but we don’t want to hear it. we always want to think we know better – but what is good for us, is that they know how we are and why we are that way, so they keep trying to help. they are the true superheroes, and they exist on the planet right now.

Thank you for defining different levels of psychopathology from a defense mechanism development. I particularly enjoy your last statement “Finally, as I get older I increasingly wonder if the “healthy person” is a mythical creation or a category that applies only to a very select few. If caring, compassion, and the ability to love unconditionally are marks of the psychologically mature, then where are these people? Where are our wise men and women?”.

Interesting, thank you. I’m not sure what exactly put me on to it but I started to try and analyse what makes me think I don’t have a personality disorder if I have struggled with low mood for most of my life – what makes me different from someone with a Cluster C PD? Although I certainly am (too) self rather than other-blaming, I wonder if your conceptualisation does make sense for those in Cluster C? What about the avoidant personality? Are they other-blaming too? You would expect them to be more self-blaming perhaps? And also I hear people with BPD tend to engage in a lot of self-hatred and shame, which sounds very self-blaming…